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Mult level disk replacement

Brownbomber2BBrownbomber2 Posts: 1
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
I have degenerative disks at L4 - L5 and have been told that I need spinal fusion to fix the problem. I have also been told by the surgeon that in a couple of years after the fusion, I will need the same surgery to repair the disks above the original surgery, because of the pressure it will put on those disks, causing their failure. I don't like the sound of that, it sounds like a dominoe effect to me and I wonder where it will stop. I have read all I can about disk replacement with flexible disks, but frankly am not finding much info that sounds promising. I am 54 years old and am a letter carrier. I walk up to 10 miles daily and am reqired to lift up to 70 pounds. I have enough leave built up to be off of work about 12 weeks. This is not work comp related so after that I am without pay. I have heard there are two level replacements being done, but I cannot find anyone that talks about that, only one level. Does anyone know of a good surgeon in the midwest, Missouri would be nice, that is competent and will do multi level replacements. I have also read that the Charite disk is not a good disk to use. Any information would be appreciated.


  • Welcome to Spine Health. If you do a search at the top of the page for ADR, you should be able to find many threads discussing single and multiple level disc replacements.

  • Before you get your heart set on having a multi-level disc replacement, you might want to talk with your insurance company. This procedure is not commonly covered in the US...some companies will cover it; others will not.
  • Yes it seems to be a dominoe effect. So the longer you wait the better off you will probably be. Have you tried PT or injections?
  • Hi Paul. Welcome to Spine-Health.

    It's true that the domino effect happens, or CAN happen after a fusion. I'm over a year out from a 3-lvl ACDF and almost four months out from an L4/5 fusion and in PT for both my cervical and lumbar spine. My PT says that the reason that PT is imperative after any fusion surgery is to teach you, the muscles and the vertabrae to align things properly creating good posture and once everything is in alignment and you continue to keep them there with correct posture, etc., your chance of adjacent disc problems are greatly reduced.

    I don't know if this is true or if we can truly make this happen, but this is what I've been told. For me, only time will tell.

  • SpineAZSpineAZ WiscPosts: 1,084
    I had an L4-S1 fusion in 1993 and 17 years later I had L3-4 fused. BUT, it wasn't due to disc having more pressure on them, it was that my L3 vertebrae slipped forward (spondylolisthesis). So if it were not for this I would not have needed additional surgery.

    So everyone is different. The 17 years were the most active 17 years of my life (from my mid 20's to now 43).

    I am a fusion advocate for the right patient. The right surgeon will work with you and make sure the fusion is right for you and then perhaps some PT to improve your core muscles. The key to having a fusion work is to follow proper body mechanics from the first day of recovery onward. Someone who has a fusion and chooses to go back to a heavy job (lifting, hauling, etc) or who ignores the need to take care of the spine in how they do things can accelerate the need to have further surgery down the road. There are cases where even when things are done right further surgery is needed down the road. And there are cases where people go back to overly active lives and never again have a problem.

    Many insurance companies will not cover artificial disc replacement so the firs step is to check with your insurance (unless you have the financial ability to cover all the costs).
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Hello,

    I can relate to your story. I was a nurse aide for 12 years and had a major injury in 2002 which changed my life forever. I waited until 2009 to have my surgery and did every conservative treatment out there. I believe in my case this was a big mistake. My doc said that because I waited so long I have major nerve damage in my legs and was falling down a lot. Anyways, I had a combination of ADR and fusion. Anterior fusion at L5-S1 and ADR with Pro-disc at L4-L5. Doc explained to me the same thing about fusion and needing surgery years down the road for stress on other discs. With the combo, the stress will be on the ADR and that it can take it. This will last for 25 years and by then I will be 65. Doc said that I will not need a revision but will have more pain and stiffness that you would normally experience with aging.Like I said, this is based on my case and you should talk to others on this forum who have experience with fusion and ADR. Do your research and get lots of opinions from other docs. I had consults with 6 different surgeons before I made up my mind and I have no regrets!!! Good luck!!!
  • Paul,,

    Usually you are told when you have fusion and degenerative disc disease that you cannot lift and you need to get a job that allows that.

    I changed from medical field to teaching. This is to protect your instrumentation and placing pressure on the one below and above your fusion as your say.

    I am very careful with my fusion and hardware because of this.

    I am 58 and now not active at all. I had four consults and chose the neurosurgeon.

    Your doctor usually writes a letter stating you need to be in a job with the limitations and this is not a good as new surgery and the job you do will put pressure on your back. Seems you could ask for mail clerk so you can protect your spine. If your Doctor promises you "good as new" and no pain, run from him as this cannot be guaranteed.

    Mine was a three level, necessary for functional support with BAK cages metal rods and screws, metal woman I am. It gave me my function back but still had the achey breaky pain.

    Good Luck and with several opinions, you can decide for your personal situation.

    I did well except for the car wreck afterwards damaging other things. BJ
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